Provider Demographics
NPI:1962615195
Name:NANCY EL-HITAMY AMIR,
Entity type:Organization
Organization Name:NANCY EL-HITAMY AMIR,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-228-0030
Mailing Address - Street 1:9577 HUEBNER RD
Mailing Address - Street 2:BLDG 4
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1687
Mailing Address - Country:US
Mailing Address - Phone:210-228-0030
Mailing Address - Fax:210-228-0277
Practice Address - Street 1:9577 HUEBNER RD
Practice Address - Street 2:BLDG 4
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1687
Practice Address - Country:US
Practice Address - Phone:210-228-0030
Practice Address - Fax:210-228-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05239TG152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082267802Medicaid
TX80296QOtherBCBS OF TX
410045447OtherMEDICARE RAILROAD
TX8497822OtherCIGNA HEALTH PLAN
TX80296QOtherBCBS OF TX
TX082267802Medicaid
TX=========OtherUNITED HEALTHCARE
TX80296QOtherBCBS OF TX
TX1962615195Medicare NSC